Histological Organisation of the IVD:

 The intervertebral discs are cartilaginous, articulating structures between the vertebral
bodies that allow movement (flexion, extension, and rotation) in the otherwise rigid anterior
portion of the vertebral column.
 The discs form a very complex system, with an outer anulus fibrosus surrounding a central
nucleus pulposus.
 Collagen fibers continue from the anulus into the adjacent tissues, tying this
fibrocartilaginous structure to the vertebral bodies at its rim, to the longitudinal ligaments
anteriorly and posteriorly, and to the hyaline cartilage end plates superiorly and inferiorly.
 The cartilage end plates in turn lock into the osseous vertebral end plates via the calcified
cartilage, with few, if any, collagen fibers crossing the boundary.
 The normal human intervertebral disc in adulthood consists of a large amount of extracellular
matrix interspersed by a small number of cells that make up approximately 1% of the total
volume.

Composition

o annulus fibrosus
 outer structure that encases the nucleus pulposus
 composed of type I collagen that is obliquely oriented, water, and proteoglycans
 characterized by high tensile strength and its ability to prevent intervertebral
distraction
 remains flexible enough to allow for motion
 high collagen / low proteoglycan ratio (low % dry weight of proteoglycans)
 fibroblast-like cells – more elongated
 responsible for producing type I collagen and proteoglycans and ?collagen
type II?
 Nerves and blood vessels are both present to a limited degree in the healthy adult
disc, restricted to the outer few millimeters of the anulus fibrosus.
 A small number of mechanoreceptors are also present, most commonly having the
morphology of Golgi tendon organs, a few Ruffini receptors, and even fewer pacinian
corpuscle
o nucleus pulposus
 central portion of the intervertebral disc that is surrounded by the annulus fibrosis
 composed of type II collagen, water, and proteoglycans
 approximately 88% water
 hydrophilic matrix is responsible for height of the intervertebral disc
 characterized by compressibility
 a hydrated gel due to high polysaccharide content and high water content
(88%)
 proteoglycans interact with water and resist compression
 Aggrecan is a proteoglycan primarily responsible for
maintaining water content of the disc
 viscoelastic matrix distributes the forces smoothly to the annulus and the
end plates
 low collagen / high proteoglycan ratio (high % dry weight of proteoglycans)
 chondrocyte-like cells – more round and oval, sometimes with a capsule around
them.
 responsible for producing type II collagen and proteoglycans
  survive in hypoxic conditions
o The cartilage end plate
 The Cartilage End Plate in humans functions in early life as a growth plate for the
adjacent vertebral body; its structure is typical of that seen in the epiphyseal growth
plate of long bones.
 This structure is lost during skeletal maturity, so that, by adulthood, the cartilage end
plate is a layer of hyaline cartilage (approximately 0.6 mm thick) with calcified
cartilage adjoining the bone.
 Collagen type II
 Largely composed of water
 Contains chondroblasts and chondrocytes singularly and or in lacunae.

 It occupies the central 90% of the interface between the disc and the vertebral body,
encompassed by a ring of bone that forms via the epiphysis fusing with the vertebral
body in this rim region.